Organization
GARY AND MARY WEST SENIOR SERVICES, INC.
Active
Other names
Gary and Mary West PACE
Organization subpart
No
Provider details
NPI number
Authorized official
KANNAMMA KANNAN (QI AND COMPLIANCE DIRECTOR)
(760) 280-2232
Entity
Organization
Contact information
Practice address
1706 DESCANSO AVE, SAN MARCOS, CA 92078-2514
(858) 412-7000
Mailing address
1706 DESCANSO AVE, SAN MARCOS, CA 92078-2514
(760) 280-2230
Taxonomy
Speciality
Code
Description
License number
State
251T00000X
PACE Provider Organization
Primary
—
—
Other
Enumeration date
11/30/2017
Last updated
12/10/2019
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